Avoiding post-partum MS worsening

Last updated: 18th November 2014

Background

Of those women diagnosed with MS, most are diagnosed in their 20s and 30s when they are making decisions to start a family. This means that many young women with MS are faced with difficult decisions about getting pregnant and the possible negative consequences of pregnancy on the course of their MS.

It is widely recognized that the number of relapses of MS decreases during pregnancy, but increases in the first three months after childbirth.

Current clinical practice is to stop all disease-modifying drugs in women planning to get pregnant.

After the birth, it is important to reduce the risk of relapses. So some neurologists suggest re-starting disease-modifying drugs as soon as possible after birth.

Study

October’s Multiple Sclerosis Journal reports a study carried out in France between 2012 and 2013. The researchers wanted to see if restarting natalizumab therapy had an impact on lowering relapse risk after delivery.

The researchers observed 24 patients who had stopped taking natalizumab when they decided to have a baby. In six of these, MS activity got worse. Since these six women had very active MS, the researchers decided to restart natalizumab soon after delivery.

Early natalizumab redosing after delivery led to disappearance of disease activity in all but one of the six patients. Five of the six patients with very active MS had both clinical and radiological improvement, and natalizumab prevented post-partum relapses.

These findings support the idea of avoiding delays after pregnancy before starting natalizumab therapy.

Read the original paper

 

Almudena and her husband play with their young son at the zoo

Madrid, Spain, 10/2011. Saturday afternoon at the zoo is a time for Almudena and her husband to lavish attention on their son. The outing will fatigue Almudena, but she recognises the need for a 3-year-old boy to burn off energy and be out exploring the world. Credit: Lurdes R. Basol. Published here by kind permission of the European Multiple Sclerosis Platform.

A young Chinese woman sits between her parents and grandparents on a bed in a small bedroom. Her parents touch her arm protectively. Everyone looks at the camera with a serious expression.

Xiao Yan (a pseudonym) third from the right, is 21 and from Jilin province. She has had MS for 3 years. Xiao Yan (a pseudonym) third from the right, is 21 and from Jilin province. She has had MS for 3 years. Reproduced with the kind permission of Li YouHao,© 2014 Li Yu Hao